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Ĥ was always the least used Esperanto letter (though it usually has more dictionary entries than ĵ), and most of its uses are in Greek etyms, where it represented chi. Since the latter is pronounced [k] in most languages, neologistic equivalents soon appeared in which "ĥ" was replaced by "k", such as teĥniko→ tekniko ("technology") and ĥemio→ kemio ("chemistry"). Some other ĥ-replacements followed unusual patterns, such as ĥino→ ĉino ("Chinese [person]").

These additions and replacements came very early and were in general use by World War I. Since then the imminent demise of ĥ has been often discussed, but has never really happened. There are very few modern ĥ-replacements, notably koruso for ĥoro ("chorus"). Some ĥ-words are preferred to existing replacements (old or new), such as ĥaoso vs. kaoso ("chaos").

Several words commonly use ĥ, particularly those of non-Greek etymology (ĥano ("khan"), ĥoto ("jota"), Liĥtenŝtejno ("Liechtenstein"), etc.) or those in which there is another word that uses "k" in that context. The latter include: